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. 2021 Apr 8:10:20480040211006582.
doi: 10.1177/20480040211006582. eCollection 2021 Jan-Dec.

Risk assessment in aortic aneurysm repair by medical specialists versus the American College of Surgeons National Surgical Quality Improvement Program risk calculator outcomes

Jan van Schaik  1 , Tessa M Hers  1 , Carla Sp van Rijswijk  2 , Maaike S Schooneveldt  3 , Hein Putter  4 , Daniël Eefting  1 , Joost R van der Vorst  1
Affiliations

Risk assessment in aortic aneurysm repair by medical specialists versus the American College of Surgeons National Surgical Quality Improvement Program risk calculator outcomes

Jan van Schaik et al. JRSM Cardiovasc Dis. .

Abstract

Objective: The aim of this online clinical vignette-based survey study was to compare risk assessments by vascular surgeons, anaesthesiologists and interventional radiologists involved in treating patients with aortic aneurysms in the Netherlands with the NSQIP risk calculator outcomes.

Methods: Participants, recruited using purposive sampling, provided their estimation of the likelihood of postoperative complications and events following aortic surgery in five fictional cases. These cases were subsequently scored using the NSQIP calculator. The risk assessments were statistically analysed using the ANOVA and student t-test.

Results: All participating specialists i.e. twelve vascular surgeons, ten interventional radiologists and ten anaesthesiologists completed the survey. In the vast majority of outcomes and vignettes, no significant differences were found between various specialists, whereas significant differences were found between the NSQIP risk calculator outcomes and the combined risk assessments of the specialists. Overall, specialist risk assessments differ from the NSQIP, but neither particularly higher nor lower compared to the risk calculator.

Conclusions: Risk assessment by vascular surgeons, anaesthesiologists and interventional radiologists differs significantly with NSQIP risk calculator outcomes, within the framework of both endovascular and open aortic aneurysm repair. Based on these results, implementing the NSQIP risk calculator in preoperative workup could be of added value in both patient planning as well as adequately informing patients for obtaining consent.

Keywords: National Surgical Quality Improvement Program risk calculator; Risk assessment; anaesthesiologists; interventional radiologists; vascular surgeons.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Overview of risk assessments patient vignette 1.
Figure 2.
Figure 2.
Overview of risk assessments patient vignette 2.
Figure 3.
Figure 3.
Overview of risk assessments patient vignette 3.
Figure 4.
Figure 4.
Overview of risk assessments patient vignette 4.
Figure 5.
Figure 5.
Overview of risk assessments patient vignette 5.
See this image and copyright information in PMC

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